Archived: OHP - Sutton Coldfield Group Practice (SCGP)

We carried out an announced comprehensive inspection at OHP-Sutton Coldfield Group Practice (SCGP) on 15, 16, 22 and 23 July 2019 as part of our inspection programme.

We based our judgement of the quality of care at this service on a combination of:

• what we found when we inspected
• information from our ongoing monitoring of data about services and
• information from the provider, patients, the public and other organisations.

We have rated this practice outstanding for providing well led services and for the older people population group.

• The practice had undergone significant redesign bringing together six practices and developing centralised systems and processes. The practice had strong leadership and a committed team to deliver a comprehensive and ambitious service redesign programme. The staff team were motivated, were receptive to new ideas and innovation and responsive to their populations needs. There was a clear emphasis on delivering high-quality person-centred care. Leaders had a proven track record in successfully delivering service improvement including supporting inadequate practices and delivering the innovative admissions avoidance scheme.
• The practice had a clear collective vision and plans to support an effective, efficient and sustainable service that met patients’ needs.
• The practice was proactive in supporting its most frail elderly patients. The practice had continued to develop and expand their successful self-funded scheme to help reduce avoidable admissions among frail elderly patients. The practice employed three senior matrons who organised safe early discharge through working with secondary care clinicians and a range of local services within the health, social care and the third sector. Analysis of the scheme estimated in the last year that a significant number of hospital bed days had been saved; along with associated costs. The practice advised that the project nurses had undertaken on average 36 admission avoidance interventions per month and 30 discharge reviews per month preventing a number of readmissions. The practice had developed strong relationship with local hospital consultants in supporting their admissions avoidance programme over the last four years.

We have rated this practice as good for providing safe, effective, caring and responsive services.

We found that:

• The practice provided care in a way that kept patients safe and protected them from avoidable harm.
• Safety was central to the service redesign. The practice had implemented various safety netting processes to ensure patients received safe care including, safeguarding arrangements, clinical template redesign and systematic reports to ensure patients received appropriate follow up and care.
• Learning from incidents and safety alerts were well embedded and shared with staff locally and nationally.
• Patients received effective care and treatment that met their needs. Patient outcome data showed performance was in line with local and national averages. The practice demonstrated strong performance in relation to uptake of childhood immunisations across most of the practice sites.
• Staff were well supported in their roles and responsibilities. There was a strong learning culture within the practice and support for innovation.
• We saw innovative approaches to providing integrated person-centred care including admission avoidance scheme and in relation to promoting healthy lifestyles.
• Staff dealt with patients with kindness and respect and involved them in decisions about their care.
• The practice organised and delivered services to meet patients’ needs. The practice recognised that access was an area for improvement and had taken a comprehensive and holistic approach to redesigning the staff structure and appointment system to meet the needs of patient care and provide future sustainability. The new appointment system had been successfully piloted with recognised benefits identified.

Whilst we found no breaches of regulations, the provider should:

• Review health and safety risk assessments across sites to ensure issues relating to individual practices are not missed.
• Improve systems and processes for undertaking infection control audit and follow up of actions.
• Review practices at each site to ensure consistent approach is used in checking emergency medicines.
• Review areas where there is higher than average exception reporting to identify if this may be further reduced.
• Continue to review patient access by telephone to ensure actions taken to improve access are working.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care